Cancer is a such a strange battle to fight because our methods of combating it are largely reactive rather than proactive. Often, the disease is already well-entrenched before the person is aware of what’s happening. Obviously, not all types of cancer hide their presence, but many do. Through my job, I support the Leukemia and Lymphoma Society by participating in their Light The Night walk. Recently, I received an email from them telling the story of a man who discovered his Stage 4 lymphoma only after donating blood. Crazy. We go for our annual exams, we do our own monthly self-checks (or we purport to), but there are limits to these preventive measures.
There’s a list of criteria that can help assess factors that may be linked to the BRCA1 or BRCA2 mutation. I hit on 3 of the 7. The BRCA gene test is simple, 10 minutes maybe. My wonderful healthcare provider sat me down with a bottle of Scope mouthwash and a vial. I hadn’t had anything to eat or drink for the past hour when I was advised to crack open the mouthwash. A capful, swish for an extraordinary amount of time, spit in the vial. Repeat. And now, just spit, no mouthwash necessary. My parting gift was the remaining mouthwash. It was exactly two weeks later when my doctor called.
The results of my regular blood work, the kind you have done at your annual exam? That had been read over the phone, so when she asked me to make an appointment, my stomach sank. I just knew. Expect the worst, hope for the best: that would be my mantra. I was absolutely not prepared for how shaken I was by just a phone call. I was at work, my productivity tanked. I wanted to leave, but still had things to do. So, in absence of being able to leave, I communicated. I sent texts to my amazing mom and my incredible cousin, Kate. I emailed my closest friend. I had a week until my appointment and in the meantime, I was going to enjoy myself. It was a short work-week in preparation for America’s Birthday. Bud Lights, boats, sparklers, fireworks and not an ounce of anxiety.
The thing is, I always knew this was a 50/50 shot. I was always prepared for the possibility that this mutation might exist in me and that I would have that stupidly high risk (84%!) of having breast cancer at some point in my lifetime. To me, a percentage that high makes it a “when” not an “if”.
I knew when she looked at me what the results were. Faces are so telling, and I think she felt bad. Out of almost 2,000 patients and 3 years in her own practice, I was the first positive result that she’d had. We discussed options. Plan A: a mammogram followed by a breast MRI in 6 months, followed by another mammogram in 6 months, followed by another breast MRI in 6 months and so on for, what? The foreseeable future? And then hope that nothing cropped up in the 6 months between those visits?
Or, plan B, a Prophylactic Bilateral Mastectomy (PBM, as it’s known in the BRCA Sisterhood). It’s radical, isn’t it? A 26-year-old removing her breasts because of a risk that something may happen. I don’t have children, I’m not married, but those are things I want. So that’s the next step. I didn’t get to choose this fate but I do get to choose my life.